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Intussusception in childhood: role of sonography on diagnosis and treatment
M Bartocci1, G Fabrizi2, I Valente2
1Department of Radiological Sciences, Radiology Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy ; Via Monte Nagni n°5, 06034 Foligno (PG), Italy.
Insights
Ultrasound is crucial for diagnosing pediatric intussusception, accurately identifying cases and guiding treatment decisions. Future applications may include non-surgical, ultrasound-guided reductions, minimizing radiation exposure.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
- Emergency Medicine
Background:
- Intussusception is a common cause of acute abdominal pain in children.
- Accurate diagnosis and appropriate treatment are vital for favorable outcomes.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic role of ultrasound in pediatric intussusception.
- To assess ultrasound's utility in guiding non-surgical treatment options.
Main Methods:
- Retrospective study of pediatric patients with acute abdominal pain.
- Analysis of ultrasound examinations performed between November 2007 and June 2013.
- Comparison of ultrasound diagnoses with final discharge diagnoses and treatment choices.
Main Results:
- Ultrasound correctly identified intussusception in 16 out of 18 patients.
- Specific sonographic findings predicted suitability for non-surgical reduction.
- Five patients underwent successful barium enema reduction.
Conclusions:
- Ultrasonography is essential for diagnosing pediatric intussusception.
- Ultrasound findings significantly aid in therapeutic decision-making.
- Ultrasound-guided non-surgical reduction is a promising future approach, reducing radiation exposure.
Objective:
The aim of this study was to determine the role of ultrasound in the diagnosis and treatment of pediatric patients with acute abdominal pain caused by intussusceptions.
Materials And Methods:
We performed a retrospective study of all pediatric patients with acute abdominal pain caused by intussusceptions and that underwent ultrasound examination at the emergency service of the Radiology Department between November 2007 and June 2013. The role of ultrasonography in the diagnosis of intussusceptions has been assessed by comparing the echographic presumptive diagnosis with the final diagnosis of discharge. Its importance in the treatment has been assessed by determining the value of ultrasound findings in the choice of the best treatment.
Results:
The ultrasound examination was positive in 16/18 patients with a final diagnosis of intussusception. Some sonographic findings seemed to be able to predict the opportunity to resort to non-surgical therapeutic options like hydrostatic or pneumatic reduction of the intestinal segments invaginated. In our casuistry, five children presented characteristics typical of this subgroup and underwent barium enema which provided the reduction of the intestinal segments involved. The future challenge will be to perform non-surgical ultrasound-guided reductions to avoid the exposure of the infants to ionizing radiations.
Conclusions:
Ultrasonography is essential not only in the diagnosis, but also it adds important elements in the therapeutic choice and could play in the future an important role in non-surgical reduction of intestinal intussusceptions in pediatric patients.
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